Pacific Neuroscience Institute, 2125 Arizona Ave, Santa Monica, California, 90404, United States.
Pacific Brain Health Center, 1301 20th St., Santa Monica, California, 90404, United States.
Mult Scler Relat Disord. 2024 Nov;91:105897. doi: 10.1016/j.msard.2024.105897. Epub 2024 Sep 18.
Lifestyle changes have been demonstrated to impact pathophysiology in Multiple Sclerosis (MS). Various diet and exercise protocols have been reported to improve symptoms and function in persons with MS. Evidence is accumulating that interventions as early as possible in the disease course are warranted. The objective of this study was to investigate the effect of a remotely delivered lifestyle program focusing on specific diet and exercise recommendations in persons with early MS.
MS patients, with disease diagnosis no more than 2 years prior, were recruited from the patient population of the MS clinic of the Pacific Neuroscience Institute. Participants followed recommendations for diet and exercise delivered via remote heath coaching. Each participant received 6 sessions with a health coach over a 12-week period. They were given parameters of a Mediterranean-type diet to follow, and specific and individualized recommendations about duration, intensity and type of exercise and physical activity. Outcome measures included Quality of Life (QOL), cognition (Symbol Digit Modalities Test, SDMT), fatigue (Multiple Sclerosis Fatigue Impact Scale, MFIS), fitness (estimated with Metabolic equivalents, METS) and other objective and patient reported outcomes (PRO). Changes in outcomes were analyzed using mixed effects general linear models and standardized pre-post differences.(Cohen's d) RESULTS: Fifteen persons with early (≤ 2 years) MS enrolled in the study, 14 of whom completed the study. We observed significant improvements in QOL (p = 0.02), SDMT (p = 0.006), fatigue(p = 0.005), fitness (p = 0.04), and other PRO and objective metrics at the end of the protocol compared to baseline. Adherence and patient satisfaction measures were high.
Specific and individualized lifestyle recommendations can be effectively delivered remotely, and may produce improvement in symptoms and function in persons with early MS. Larger controlled trials of these interventions are warranted.
生活方式的改变已被证明会影响多发性硬化症（MS）的病理生理学。各种饮食和运动方案已被报道可改善 MS 患者的症状和功能。有证据表明，在疾病早期进行干预是必要的。本研究的目的是调查一种远程提供的生活方式方案对早期 MS 患者的影响，该方案侧重于特定的饮食和运动建议。
从太平洋神经科学研究所的 MS 诊所的患者人群中招募了疾病诊断不超过 2 年的 MS 患者。参与者遵循通过远程健康教练提供的饮食和运动建议。每个参与者在 12 周的时间内接受了 6 次健康教练的指导。他们遵循地中海饮食模式的参数，并获得了关于运动和体育活动的持续时间、强度和类型的具体和个性化建议。结果测量包括生活质量（QOL）、认知（符号数字模态测试，SDMT）、疲劳（多发性硬化症疲劳影响量表，MFIS）、体能（用代谢当量，METS 估计）和其他客观和患者报告的结果（PRO）。使用混合效应一般线性模型和标准化前后差异（Cohen's d）分析结果变化。
15 名早期（≤2 年）MS 患者参加了这项研究，其中 14 名完成了研究。与基线相比，我们在研究结束时观察到 QOL（p = 0.02）、SDMT（p = 0.006）、疲劳（p = 0.005）、体能（p = 0.04）和其他 PRO 和客观指标显著改善。依从性和患者满意度测量结果很高。
特定的个性化生活方式建议可以有效地远程提供，并且可能会改善早期 MS 患者的症状和功能。这些干预措施的更大规模对照试验是必要的。
